Spondyloarthritis

What is Spondyloarthritis?

Spondyloarthritis is an umbrella term for inflammatory diseases that affect the joints and the area where the ligaments and tendons attach to the bone. The most common of these inflammatory diseases is ankylosing spondylitis, while others include psoriatic arthritis, reactive arthritis and arthritis associated with inflammatory bowel disease.

  • Ankylosing Spondylitis
    Ankylosing spondylitis is a type of Spondyloarthritis which affects the spine. Inflammatory back pain due to Ankylosing spondylitis is categorised by back pain that has been present for more than 4 weeks, typically occurring in patients younger than 45 years of age. The back pain often starts in the buttocks and lower back, and may spread to the upper back and neck. Pain is usually worse at night often leading to interrupted sleep with morning stiffness lasting more than 1 hour. The pain often improves with exercise, not with rest.
  • Psoriatic arthritis
    One of the less common types, psoriatic arthritis is an autoimmune disease in which the immune system attacks healthy tissue causing inflammation of the joints. The skin condition psoriasis usually accompanies it.
  • Reactive Arthritis
    Another less common type of Spondyloarthritis, reactive arthritis causes inflammation in the urinary tract, the eyes and joints, including the spinal joints. IBD-associated arthritis (or enteropathic arthropathies). In rare cases, those with inflammatory bowel diseases (such as Crohn's disease and ulcerative colitis) are affected by peripheral arthritis, inflammatory arthritis and arthralgia (which is joint pain without inflammation). While these conditions are not autoimmune diseases, those with inflammatory bowel diseases have a higher risk of developing these types of Spondyloarthritis.

Another less common type of Spondyloarthritis, reactive arthritis causes inflammation in the urinary tract, the eyes and joints, including the spinal joints. IBD-associated arthritis (or enteropathic arthropathies). In rare cases, those with inflammatory bowel diseases (such as Crohn's disease and ulcerative colitis) are affected by peripheral arthritis, inflammatory arthritis and arthralgia (which is joint pain without inflammation). While these conditions are not autoimmune diseases, those with inflammatory bowel diseases have a higher risk of developing these types of Spondyloarthritis.

What are the symptoms of Spondyloarthritis?

While symptoms may vary depending on the particular type of inflammatory disease, Spondyloarthritis usually begins with back pain and thus inflammatory back pain should raise suspicion of one of the spondyloarthritides (SpA). If back pain is not managed, it could progress to the fusion of the vertebrae, inhibiting mobility. Although less common, the swelling of the arms and legs is another symptom of Spondyloarthritis. Other issues that may be complications of this condition include osteoporosis, pain and redness of the eye, inflammation of the aortic heart valve, intestinal inflammation and the skin disease psoriasis.

What does treatment involve?

Since there is a strong genetic component to the development of spondyloarthritis, the Antigen B-27, it can be easily detected with a blood test to determine if a type of Spondyloarthritis is the cause of back pain. While there is no cure, Dr Griesel may focus treatment on reducing pain, improving or maintaining mobility, and reducing your risk of complications that are common with this disease.

As back pain is relieved with movement, low-impact exercise becomes a critical component to managing pain. Dr Griesel may also advise physical therapy for this same reason. In addition, medications such as non-steroidal anti-inflammatory drugs, corticosteroid injections, anti-rheumatic drugs and TNF alpha-blocker drugs may be prescribed.